HomeMy WebLinkAbout0140 BAY ROAD - Health (2) (701/ 0) q
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Department of Health,Safety,and Ertvironmental Services 'L t o 9-7
Public Health Division Data
� 367.Main Street,I lyannis MA 0260
RARNurAsM ' Time 1130 Fee Pd.
�• t639 .`� Date Scheduled OIL. I s'`,
I QED NUS .
Soil Suitability m
it Assessent for Sewage Disposal
Performed By: 6AxTE 1
NyL- 164e Witnessed By:
LOCATION & GENERAL INFORMATION
Owner's Name FPnNK b.Lo1eTr, Ja-•
Location Address *k �� ,r'M�5 g
Address 1847 PR c'�Moi..•T DQiv@
TRof• MI. 48059
Engineer's Name n�ax,ta. -( ..,tee •-+�
Assessor's Map/Parcel: MAP -7 Pn ae E a.. I q
NEW CONSTRUCTION ✓ REPAIR
Telephone N 5o9- ¢'LS -9 1 3 1
vA`�••+T
Slopes(%) Surface Stones
Land Use
ft Drinking Water Well tA
Distances from: Open Water Body Z�—R Possible Wet Area tj
tl
Drainage Way '��R Property Line
R Other
of test holes&perc tests,locate wetlands in proximity to holes)
SKETCH:(Street name,dimensions of lot,exact locations
Y A S N F E E N O A 0
I
' es
)0 •1 W
� x i9v9'ro•� � •i0•
9.9 y I
I O
O Y
_
L 1
ea
• � W j1 x sa,s �>, e
.i9V9'00'• )•S
39•
)9.1
1 „ /p9
I II
19 I $G
o
.. i 1J•yo
8
EDOE eon°"a
Depth to Bedrock — 5 C>
Parent material(geologic) amP
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
Estimated Seasonal High Groundwater
IS
i BETCRNIINATTON FOR SEASONAL.HIGH 'WATER TABLI✓
Method Used: m.
in. Depth to soil mottles: � IS, z n.
Depth Observed standing in obs.hole: in. Groundwater Adjustment +I
Depth to weeping from side of obs.hole: �.ti Ad factor Adj.Groundwater Level i 55
Index Well N Mlw'19 Reading Date: 1.9� Index Well level j
RERCOLATION TEST Date s.16.9i Time 11
Observation Time at 9"
Hole N 2
a raP I� C HeQ Time at G"
Depth of Pere s"fbor
Start Pre-soak Time Q
. I I ,.15 Time(9"-6")
End Pre-soak
I I'.1 S:30 � vry h•P�tc. 'ra 'fin T"Q y4•f6 — hs SvA'�f=
ftrc-�� C�")S'la•F�R` �-M 11-+ I 1 ha�rF
Rate Min./inch G
Site Suitability Assessment: Site Passed ✓ Site Failed:
Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant
I
Hole # t
DEEP OBSERVATION I-IOLE LOG Soil other
Soil Texture Soil Color
Depth from Soil horizon (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
0
Surface(in.)
e rti/P F-.IA VCcoM Pr1-rE NC'efll�S
0•3"
3""_ g•" s role�a��c� ,,*Eb-F..t:
b . 23", �
Io�r R- S I S f+/A Sri..ru-.E G2 Qos7
a--I/(. Lc-E C—0-0-N Law-.�
23"-11e" G
DEEP OBSERVATION MOLE LOG Ilolc # z
Soil Color I Soil Other
Depth from Soil Horizon Soil Texture Mottling (Structure,Stones,Boulderes.
(USDA) (Munsell)
Surface(in.) a
1 �1rxn E �
2'DecP Pt P
3Vr' G c,S •
2`5`A IOM 3oS
I
� I
DEEP OBSERVATION HOLE LOG 1<Iolc#
Depth from Soil Florizon Soil Texture
Soil Color Soil Other
Surface(in.)
(USDA) (Munsell) Mottling (Structure,Stones,Bouldcres.
_—
---------
I
i
i
Hole #
DEEP OBSERVATION IIOLE LOG o Soilther
Depth from Soil Horizon Soil Texture (M�sell) Mottling (Structure,Stones,Boulderes.
Surface(in.) (USDA) l o
I
I
j
i
i
I
i
I �
I
I I '
I I
Flood Insurance Rate Mao:
I
Above 500 year flood*boundary No— Yes
I
Within 500 year boundary No✓ Yes
I
Within 100 year flood boundary No✓ Yes
Ihepth LQ9 Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
� ('Prtilication
1 certify that on `' °►5 (date)I have passed the soil evaluator.examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required t 'ning,expertise and experience described in 310 CMR 15.017.
I
. T)ate 2 I 97
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